alternate ways of treating borderline personality disorder

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this thread is made to discuss and debate alternate ways of treating borderline personality disorder. the point is to "think outside the box" and "stirring the pot" is also acceptable and encoraged. please respond to subject only and not the specific member who is posting the subject. for example if somebody says - i think the world is flat - please do not respond with - the reason you think the world is flat is because you're an idiot. i can't wait to read other's ideas of alternate ways to treat boderline personality disorder. let the posting begin.

Specializes in icu.

i think it was the last thread i did i talked about how a psychiatrist said about a revolving door boderline at the hosp "this is one of those patients you want to euathanize". somebody said well he was just venting. have you ever heard an oncologist say about a revolving door chemo therapy patient - this is one of those patients you want to euthanize? i doubt it. the fact that he would make such a statement shows that he thinks of this particular kind of patient in a bad way. and does anybody else have alternate ways to treat borderline patients. and to mercyteapot - once they're in africa or the amazon then they will live like the people there do.

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Well to answer the original question, Dialectical Behavior Therapy can be effective with borderlines. Marsha Linehan wrote 2 books: Cognitive Behavior Therapy for Borderline Personality Disorder and Skills Training Manual for Borderline Personality Disorder. They are EXCELLENT. I'm looking into training so that I could do skills training groups at my hospital. Although the books emphasize that the best way to treat it is not in the hospital, but in intensive therapy/skills training outpatient. The books also give a great view into the mind of a borderline, and have a great deal of empathy for the very real pain these people are in. I highly recommend them for someone who is interested in learning more about treating borderline patients.

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]i think it was the last thread i did i talked about how a psychiatrist said about a revolving door boderline at the hosp "this is one of those patients you want to euathanize". somebody said well he was just venting. have you ever heard an oncologist say about a revolving door chemo therapy patient - this is one of those patients you want to euthanize? i doubt it.[/b] the fact that he would make such a statement shows that he thinks of this particular kind of patient in a bad way. and does anybody else have alternate ways to treat borderline patients. and to mercyteapot - once they're in africa or the amazon then they will live like the people there do.

Chemo patients don't usually present with the relentless behavioral challenges that borderline patients do.

Borderline patients are one of the most frustrating populations on earth to deal with. Because they are often intelligent, their behavior SEEMS to be willful. And because their disorder is so entrenched and our methods for dealing with them are often so ineffective, the grim prognosis adds to the frustration. That doesn't make negative attitudes right, but it certainly does make them understandable.

Any meaningful discussion about alternative treatment has to acknowledge the intense frustration now present on the part of many caregivers. It may be that this extreme discouragement is exactly the proof needed to say that current treatment is not working for most borderline patients. In order to make real progress, both the caregivers and the care recipients need new ways of looking at old problems.

Hsieh, I would really appreciate your response to my earlier post asking for clarification. That would be Post #29. Thank you.

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Specializes in icu.

to rnwriter post #29 - yes that is exactly what i'm saying. and as far as making nasty comments about patients - cancer is very difficult to treat and sometimes not curable - but even though cancer is difficult you still don't make nasty comments about people with cancer. that's because you know it's not their fault. when a practitioner makes nasty comments about a diseased person that means the practitioner holds that patient responsible for their disorder. we had one sad pt who was sent to state who had cut both arms so much they were nothing but 99% red cut marks on her arms. somehow she also got razor blades on the unit and swollowed them. i can't help but think what would happen to this person if she were dropped in a third world country where nobody would have the time or money to pay attention to her. how is it inhumane to put somebody in an enviroment where they get better? a place where people have to put all their energy into keeping themselves and their kids alive. and don't have any energy left over to take care of somebody who says they want to die.wouldn't we ALL be changed by going into such an enviroment?

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Specializes in NICU, Psych, Education.
how is it inhumane to put somebody in an enviroment where they get better?

No one is asserting that it would be inhumane or unethical to make people better. The concern is that there's no evidence that exile to Africa heals people who already suffer from borderline personality disorder. In fact, there are significant risks which make it unthinkable to most of us. You said yourself that it takes all of a person's energy to survive in a third world country. Imagine if a person with already poor coping skills were placed in the same environment. If the person did not die from self-harm/suicide related to worsening psychological issues, there's still a significant possibility of death from exposure to disease or hunger.

The other issue: If it became widely known that psychological 'troublemakers' got shipped off to another country, would that truly decrease the incidence of mental health problems, or would it simply lead to more untreated people with mental illness?

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Specializes in Cardiac.

The other issue: If it became widely known that psychological 'troublemakers' got shipped off to another country, would that truly decrease the incidence of mental health problems, or would it simply lead to more untreated people with mental illness?

That's a great point Eric. It would severly restrict people from seeking any kind of treatment if our therapeutic goal was to get rid of people who we see as 'untreatable' in our society.

If we, as nurses, think it's inhumane and unthinkable to ship them off someplace else, what does it say to the patients? To me, it says, we are incapable of treating certain disorders. Now boarderliners, then criminals, maybe people with bipolar....I mean, if we get away with it once, why not send all people with mental illnesses away? Sounds like 1933 Germany...

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Specializes in Med-Surg, Geriatric, Behavioral Health.

Very good discussion.

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Specializes in Happily semi-retired; excited for the whole whammy.
That's a great point Eric. It would severly restrict people from seeking any kind of treatment if our therapeutic goal was to get rid of people who we see as 'untreatable' in our society.

If we, as nurses, think it's inhumane and unthinkable to ship them off someplace else, what does it say to the patients? To me, it says, we are incapable of treating certain disorders. Now boarderliners, then criminals, maybe people with bipolar....I mean, if we get away with it once, why not send all people with mental illnesses away? Sounds like 1933 Germany...

You know, it's funny you should mention 1933 Germany, because I was thinking my primary problem with this whole idea is reflected in that prayer written by a Lutheran minister about the Nazi reign:

When they came for the Catholics, I said nothing because I was not a Catholic.

When they came for the Jews, I said nothing because I was not a Jew.

When they came for the union members, I said nothing because I was not a union member.

When they came for me, no one said anything, because they all had already been taken.

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Specializes in icu.

if somebody said to me you can go live in a third world country for (?) six months (?) and they would take care of my expenses and responsibilities here i would jump at the opportunity. i think it would be great to experience what others do. the idea of sending a disordered person to another enviroment is not a punishment but a development opportunity - just as it would be for any of us. and i would still like to hear other people's ideas of alternate treatments - all's i hear other people talk about is traditional treatment.

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Specializes in Happily semi-retired; excited for the whole whammy.
if somebody said to me you can go live in a third world country for (?) six months (?) and they would take care of my expenses and responsibilities here i would jump at the opportunity. i think it would be great to experience what others do. the idea of sending a disordered person to another enviroment is not a punishment but a development opportunity - just as it would be for any of us. and i would still like to hear other people's ideas of alternate treatments - all's i hear other people talk about is traditional treatment.

You still refuse to tell us who is going to pay for this. I assume we can all agree that there isn't a chance in Hades that public and private funded insurance is going to agree, and it is unlikely that patients themselves will have the resources or inclination to pay their own way. You may consider such details irrelevant, but in reality, no tickie=no washie.

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Specializes in icu.

somebody who wants to spend money to pioneer research in alternate treatments for boderline personality disorder. now excuse me, i'm going to go watch meerkat manor on the animal planet channel.

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Specializes in Acute Care Psych, DNP Student.

This is the most (((unusual))) thread I have ever read on this forum. My mother is a borderline. Dropping her off in Africa for six months would not help her. She would just struggle for survival and would suffer like anyone else there. The patterns are deeply ingrained. I would imagine violent behavior might occur once a borderline came home to the US. It's not like correcting attitude and behavior problems in young people like can be done with boot camp. This is not a behavior slide that can be adjusted by a change in environment. Borderlines have maladaptive behavior that is deeply ingrained like the color of the sky in my world and yours.

Also, borderlines have a terror of being abandoned. It is distinctly different than our normal fear of losing those we love, or being alone. Nothing like dropping them off in a 3rd world country away from their home country to make them feel abandoned. Many would simply have a psychotic break and/or figure out how to off themselves. If they don't commit suicide then they would come home injured and hurt worse off from being abandoned. This is not even addressing the ethical issues that remind me of the holocaust. Thank you to a previous poster for bringing that up.

I think it is naive to think that some sort of survival experience might make the disorder go away. It's a Maslow's hierarchy issue to a large extent. If I were dropped off in Africa for six months, you bet I wouldn't be so concerned about my various physical ailments. I would be too busy trying to meet basic survival needs. That doesn't mean that my physical ailments aren't there though. Same with borderlines. There is some extremely bizarre logic here and denying of Maslow's.

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